Health information management : journal of the Health Information Management Association of Australia最新文献

Background: National Personal Health Records (PHRs) have been proposed to improve the transfer of medication-related information during transition of care. Objective: To evaluate the concordance between the medications captured in the Australian national PHR, My Health Record (MyHR), and the pharmacist obtained best possible medication history (BPMH) for patients upon hospital admission. Method: This prospective observational study used a convenience sample of hospital patients. For newly admitted patients, the investigating pharmacist obtained a BPMH and then compared it to the medication list captured in MyHR. Upon comparison, the medications were categorised into either complete match, partial match or mismatch. Medications with a complete or partial match were grouped together. Medications with deviations were then assessed for risk based on their potential consequence, and reported descriptively. A multivariable logistic regression was conducted to assess the factors associated with a drug being mismatched. Results: A total of 82 patients were recruited, with a cumulative total of 1,207 medications documented. Of the 1,207 medications, 714 (59.2%) medications were documented as a complete/partial match. The remaining 493 (40.8%) medications were mismatched. Of the 493 mismatched medications, 442 (89.7%) were deemed low-risk deviations and 51 (10.3%) were deemed high-risk. A medication was more likely to be mismatched, rather than completely/partially matched, if it was a regular non-prescription medication, or "when-required" prescription medication, or "when required" non-prescription medication, or if it was administered parenterally. Conclusion: National PHRs may be a secondary source to either confirm a patient's medication history or be used as a starting point for a BPMH.

Background: Routine family planning data in South Africa are managed using a routine health information system, which facilitates data collection, storage, processing, presentation and dissemination. Healthcare providers generate data daily as they carry out their duties. The information generated should be used for planning and evaluating health program performance and policy development.

Objective: To explore the use of family planning information by primary healthcare (PHC) clinic managers in South Africa.

Method: A qualitative descriptive exploratory study was carried out in 11 PHC clinics in Tshwane District. Individual semi-structured interviews were conducted with 11 clinic managers. The data were analysed using a thematic analysis approach.

Results: Managers used the information to disseminate performance and feedback, monitor the program's performance and make decisions to improve the family planning service. However, they experienced challenges that hampered the effective use of the information.

Conclusion: The use of family planning information is critical for improving the performance of the program. The clinics need sufficient skilled healthcare providers who are able to provide comprehensive family planning and generate accurate and reliable information that can be used to improve the service. Collaboration between the private and public sectors is critical in monitoring the program's performance.

Background: The emergence of big data holds the promise of aiding healthcare providers by identifying patterns and converting vast quantities of data into actionable insights facilitating the provision of precision medicine and decision-making. Objective: This study aimed to investigate the factors influencing use of big data within healthcare services to facilitate their use. Method: A systematic review was conducted in February 2024, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Database searches for articles published between 01 January 2020 and 18 February 2024 and included PubMed, Scopus, ProQuest and Cochrane Library. The Authority, Accuracy, Coverage, Objectivity, Date, Significance ( AACODS) checklist was used to evaluate the quality of the included articles. Subsequently, a thematic analysis was conducted on the findings of the review, using the Boyatzis approach. Results: A final selection of 46 studies were included in this systematic review. A significant proportion of these studies demonstrated acceptable quality, and the level of bias was deemed satisfactory. Thematic analysis identified seven major themes that influenced the use of big data in healthcare services. These themes were grouped into four primary categories: performance expectancy, effort expectancy, social influence, and facilitating conditions. Factors associated with "effort expectancy" were the most highly cited in the included studies (67%), while those related to "social influence" received the fewest citations (15%). Conclusion: This study underscored the critical role of "effort expectancy" factors, particularly those under the theme of "data complexity and management," in the process of using big data in healthcare services. Implications: Results of this study provide groundwork for future research to explore facilitators and barriers to using big data in health care, particularly in relation to data complexity and the efficient and effective management of big data, with significant implications for healthcare administrators and policymakers.

In 2022 the Australian Data Availability and Transparency Act (DATA) commenced, enabling accredited "data users" to access data from "accredited data service providers." However, the DATA Scheme lacks guidance on "trustworthiness" of the data to be utilised for reuse purposes. Objectives: To determine: (i) Do researchers using government health datasets trust the data? (ii) What factors influence their perceptions of data trustworthiness? and (iii) What are the implications for government and data custodians? Method: Authors of published studies (2008-2020) that utilised Victorian government health datasets were surveyed via a case study approach. Twenty-eight trust constructs (identified via literature review) were grouped into data factors, management properties and provider factors. Results: Fifty experienced health researchers responded. Most (88%) believed that Victorian government health data were trustworthy. When grouped, data factors and management properties were more important than data provider factors in building trust. The most important individual trust constructs were: "compliant with ethical regulation" (100%) and "monitoring privacy and confidentiality" (98%). Constructs of least importance were knowledge of "participant consent" (56%) and "major focus of the data provider was research" (50%). Conclusion: Overall, the researchers trusted government health data, but data factors and data management properties were more important than data provider factors in building trust. Implications: Government should ensure the DATA Scheme incorporates mechanisms to validate those data utilised by accredited data users and data providers have sufficient quality (intrinsic and extrinsic) to meet the requirements of "trustworthiness," and that evidentiary documentation is provided to support these "accredited data."

Background: Traditionally, health placements have required practical in-person learning, including placements completed by health information management (HIM) students. COVID-19 made in-person healthcare placements largely unviable. Alternative virtual/remote placements were required.

Aims: (1) Explore the experiences of virtual/remote placements for HIM students and their supervisors; (2) Compare these experiences to the literature on barriers and facilitators for virtual/remote placement and (3) Develop best practice guidelines for the delivery of virtual/remote placements for HIM students.

Method: A cross-sectional survey asked final-year HIM placement students and their supervisors about their virtual/remote placement experiences in 2021. Survey findings were compared to 10 barriers and facilitators for remote/virtual placements identified in the literature.

Results: Students were challenged by autonomous virtual/remote placements but enjoyed their flexibility. A work schedule provides placement structure to students. The use of technology was embraced although unfamiliarity with video-conferencing software prior to placement was an issue for some students. The most common method of student-supervisor communication was email. However, students missed casual corridor conversations. The importance of maintaining a community of practice was reported in the literature and confirmed by students. Most students preferred undertaking a virtual/remote placement rather than delaying graduation. The majority of supervisors reported complete satisfaction with the placement students' performance.

Conclusion: Virtual/remote placements were a viable option for HIM students when in-person placements were impossible. Students required a work-based schedule, appropriate information technology, a dedicated workspace, familiarity with communication technologies, good communication channels with their supervisors and a supportive 'community of practice'. HIM supervisors were satisfied with virtual/remote methods of placement delivery.

Background: Medical records, encompassing patient histories, progress notes, and more, play a crucial role in patient care and treatment, healthcare communication, medico-legal matters, and supporting financial documentation.

Objective: Despite their significance, literature suggests inconsistencies in record quality and insufficient formal medical record-keeping education for medical students and residents. The study aimed to identify and evaluate the effectiveness of educational interventions by conducting a systematic review.

Method: A literature search covering 2003-2023 and review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken.

Results: The literature search identified 44 relevant studies for inclusion. Educational methods, including lectures, feedback, workshops and discussions, addressed different components of the clinical record. The review revealed positive impacts on participant satisfaction, skills and attitudes related to record-keeping. However, some studies reported no significant positive outcomes, emphasising the need for higher-level evidence. Most studies adopted a single-group pretest-posttest design, presenting challenges in control group implementation. The Kirkpatrick evaluation levels were primarily at level 2, with few studies reaching level 3. The absence of studies at level 4 suggested the need for more robust evidence. Studies targeted medical residents more frequently than medical students, with a lack of interventions during the first year of medical education.

Conclusion: Despite limitations including language bias and methodological variations, the review revealed diverse educational strategies and highlighted the necessity for more randomised controlled trials and studies providing higher-level evidence to enhance clinical record-keeping skills among medical students and residents.

Implications: Medical record-keeping educational interventions can significantly improve the documentation skills of medical students and residents, thereby enhancing patient care, communication and medico-legal compliance.

Background: When a patient is discharged from hospital it is essential that their general practitioner (GPs) and community pharmacist are informed of changes to their medicines. This necessitates effective communication and information-sharing between hospitals and primary care clinicians.

Objective: To identify priority medicine handover issues and solutions to inform the co-design and development of a multifaceted intervention.

Method: A modified nominal group technique was used to reach consensus on medicine handover priority areas. The first hour of an interactive 2-hr workshop focused on ranking pre-identified issues drawn from literature. In the second hour, participants identified solutions that they then ranked from highest to lowest priority through an online platform. Descriptive statistics were used to analyse workshop data.

Results: In total 32 participants attended the workshop including hospital doctors (n = 8, 25.0%), GPs and hospital pharmacists (n = 6 each, 18.8%), consumers and community pharmacists (n = 4 each, 12.5%), and both hospital and aged care facility nurses (n = 2 each 6.3%). From the list of 23 issues, the highest ranked issue was high workload and time pressures impacting the discharge process (22/32). From the list of 36 solutions, the participants identified two solutions that were equally ranked highest (12/27 each). They were mandating that patients leave hospital with a discharge summary, including medication reconciliation information and, developing an integrated information technology system where medication summary and notes are accessible for primary, secondary and tertiary health provider.

Conclusion: The consensus process highlighted challenges in hospital procedures where potential solutions may be implemented through co-design of a multifaceted intervention to improve medicine handover quality.

Background: Accurate documentation of tumours presents significant opportunities for advancing cancer research and improving patient care, yet it also poses challenges for healthcare management.

Objective: This study aimed to assess the effectiveness and resource implications of source data verification (SDV) in enhancing the quality of tumour documentation data, focusing on accuracy, completeness and correctness.

Method: Using tumour documentation data from a large German University Hospital, an SDV was conducted by an external audit group (group RE), comparing the data initially documented by the centre's tumour documentalists (group TD) to available source documents for the years 2016-2020. The analysis set comprised 240 cases, with exemplary data fields strategically selected across various organ entities and other tumour features. Identified errors were cross-validated by a third group (group CO).

Results: Visualisations depicted error frequencies by diagnosis year and organ entity. Potential errors were identified, providing feedback to the tumour documentation unit. However, uncertainties in error identification raised questions about the efficacy of SDV.

Conclusion: While effective in identifying errors, SDV faced challenges due to ambiguous source data and potential bias from external auditors, as well as being deemed uneconomical. The study suggests SDVs suitability for small sample validation but questions its scalability for large datasets.Implications for health information management:Alternative methods, such as data exchange interfaces to subsystems or plausibility checks, are recommended for enhancing data quality. This study emphasises the need to explore alternatives for improving data quality in tumour documentation.

Background: While the smart aged care service platform in China significantly enhances aged care services in China by integrating resources, it struggles with "data silo" issues due to the absence of data standards, leading to poor data integration, limited data-sharing and fragmented system functions. Objective: The study aimed to develop a minimum dataset (MDS) for smart aged care service platforms that constitutes core data to support real-time demand analysis and cross-regional cooperation, as well as to provide a foundation for the construction of a smart aged care data resource framework. Method: The study was developed in three phases: (1) bidding documents, policies, standards and literature were collected; (2) by analysing the content of the documents, the study constructed the structure of the MDS and extracted data elements afterward; and (3) a two-round Delphi process with 26 specialists was subsequently performed to revise the draft, and 24 institution staff invited to review and determine the MDS prototype. Results: Smart aged care service platforms included three types of users: older adults and their families; aged care organisations and regulatory authorities. The final MDS contained 122 items (26 optional items) with 6 first-level categories and 17 second-level categories. The most recognised sub-categories were nursing diagnosis, demographics and medical history. The data of government regulatory agencies was also important. Conclusion: The developed MDS provides a standardised framework for data integration and sharing in smart aged-care service platforms. Implications for health information management: The MDS can enhance data quality, facilitate personalised care, support evidence-based decision-making and promote research and innovation in aged care.